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Pharmacology · Chemotherapy: procarbazine reactions
Sample itemA man on MOPP chemotherapy for Hodgkin lymphoma drinks alcohol at a party and develops flushing, headache and vomiting. Another day, after eating aged cheese, he has a severe headache with hypertension. Which component of the regimen explains both events?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Procarbazine
Procarbazine has a disulfiram-like effect with alcohol and is a weak monoamine oxidase inhibitor, so tyramine-rich foods can provoke hypertensive reactions. Patients are advised to avoid alcohol and tyramine-rich foods and some sympathomimetics. The other components do not inhibit these enzymes.
Option by option
A. Prednisolone
Prednisolone causes hyperglycaemia and fluid retention and has no such interaction.
B. Procarbazine (correct)
Correct. This drug causes a disulfiram-like reaction and weak MAO inhibition.
C. Mechlorethamine
Mechlorethamine is an alkylating agent that causes vesicant injury and marrow suppression.
D. Vincristine
Vincristine causes neuropathy and constipation.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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